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Hello, friends! This is a re-release of episode 74, in which I dive deep into 10 tips that you can use to get the most out of therapy. This is great advice whether you are a therapy newbie, a seasoned veteran, or still thinking about whether therapy is for you.
Therapy is helpful – that’s what research says, but there are things that you can do to max out its effectiveness.
1. You don’t need to impress your therapist
This leads a lot of people to be dishonest about their progress or focus on the less important topics. You don’t need to worry about inconveniencing them. Your therapist is there because they are being paid, either by you or your insurance company, to help. This is their job – they can’t do their job appropriately without all of the correct information. So there is no need to try to impress your therapist. They’re not somebody like a friend who you want to make sure thinks well of you. Your therapist has what’s called “unconditional positive regard” which means that in general they’re going to be on your side and interested in helping and supporting you through this period. Of course, it is important to build a relationship and trust and small talk is definitely okay, but at some point, you’re going to need to dive into the shit if you want to get through it. You wouldn’t be in therapy if you were doing great already, so there’s no need to pretend like it.
2. Don’t lie to your therapist
This one sounds obvious, but it’s actually suuuper common for people to lie to their therapist. Tell part of the truth and lie about the rest. This follows from the no need to impress your therapist part, but for instance if you are trying to abstain from a behavior, but you’re worried about disappointing them, you might lie about it. Also you might lie about certain symptoms – seeing things that aren’t there, suicidal tendencies etc. Incidentally, this is why it’s really important for therapists to document. In case you weren’t being truthful about symptoms or a problem which later escalates. At the end of the day, therapists and psychologists can’t read your mind. Ultimately, you don’t need to manage your impression with your therapist, you just need to participate in the therapy.
3. Don’t be afraid to let it out and actually cry – people always apologize
This is a great one that was suggested on the Facebook group. I can’t tell you how many people apologize when they start to cry. I’m like you’re in therapy, dude. Cry! Tissues are a business expense. This is literally a place designed to be a safe place for you to access emotion. You are definitely not making the most of it if you don’t allow yourself to do that. This is different from not being able to access your own emotion, but if you’re suppressing it because you don’t want to be embarrassed, that’s something that I challenge you to work through. It can be so cathartic, revealing, and helpful to let it out emotionally in a safe space with someone who can help you work through it. There is a fear of unraveling completely, but that’s rarely the case.
4. Challenge your therapist, correct them, make them explain again
This one is sooooo important. Your therapist’s job is to understand you and learn to speak your language. If they get something wrong, tell them! It’s not mean. It’s vital. A lot of times you can actually get a deeper level of understanding from misunderstanding. For instance, I might say to a client that “it sounds like that made you feel guilty…” and they might say “no not guilty” then they help me understand that it’s more along the lines of anger and feelings of being taken advantage of. That’s something we can work with and dive deeper. Likewise, if they use jargon that you don’t understand or if they lay a concept or interpretation down and you don’t quite get it, ask them to clarify. Or even challenge them on it. This isn’t a class to be taught and you don’t have to just be passive. Don’t forget that you are paying this person and that they are up for the challenge.
5. If it’s not working, say something
This is related to some of the other ones, but try your best not to fake progress. If you are unsure, that’s okay. And if you are optimistic and WANT to feel better that’s okay too. But don’t think you will disappoint your therapist if you are not yet making progress. That might be part of the experience and it will take more time or it could be an indication that something needs to change. Your therapist will never be able to make those adjustments without knowing that they need to.
6. Find someone you are comfortable with
This one depends a bit on your situation and where you live. If you are on a government waitlist in another country, you may not have an option, but in the USA a lot of times you can change therapists if you are not satisfied or do not think its a good fit. Unless there is something immediately obvious that you don’t feel comfortable with, I do recommend giving a therapist a few sessions first before making a switch, but it’s important to remember that it needs to be right for you. Even at Kaiser you can request this, even if it feels like you can’t…you need to advocate for yourself if you don’t feel the match is right. A good fit is so important and makes a huge difference to your sessions. For example, my wife found a good one and it made a huge difference. She wants to go and that’s good!
7. Get therapy sooner
This is a funny one, but it’s true. One that came from the group. A lot of people really benefit from therapy and have a sense of guilt later on that they didn’t start it 5 or 10 years beforehand. If you have access to therapy there is no need to wait.
8. Take notes, journal during and after, review them and self-monitor
Sometimes it’s hard to take it all in. Writing notes down can help you remember, track, and integrate the information. You can look at them throughout the week and also prep for your session beforehand. If you bring the notebook with you, you can work through exercises in session as well. Sometimes you can also use it to remember what you had wanted to say.
9. Do the homework, practice the skills
Skills are skills. You can’t expect to get good at them without practice. Take the skills you learn in therapy and try your best to practice them in real life. Homework is something some therapists do – they aren’t given for no reason. If you have a problem with the homework, don’t hide that either…talk to your therapist about it. Refer to the previous advice about correcting your therapist. Otherwise, I definitely encourage you to try to go through your homework…try to do the work as that is really where you’re going to make the most progress. You only see your therapist every so often so the rest of the work is down to you.
10. Talk about your relationship with your therapist, WITH your therapist
This is a higher-level one that takes some comfort with your therapeutic relationship, but some of the really impactful stuff can come out when you actually bring issues into the room and work them out. When you talk about the dynamics between the two of you, you can get into some powerful stuff. Often the dynamics that play out elsewhere in their life will also play out in the therapy session. This happened to me recently with a client who has some difficult patterns in relationships and they were upset by something that I said that came off rough. Instead of dodging and not coming to session, they were brave and came. I was eventually able to pull out their frustration and anger and we processed it in the session and drew some parallels to their “real life”. In this way you can get a corrective emotional experience that you may have a hard time finding in your outside life.
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